Provider Demographics
NPI:1366566168
Name:ROBINSON, JEAN H (MD)
Entity type:Individual
Prefix:DR
First Name:JEAN
Middle Name:H
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CATHERINE
Other - Middle Name:JEAN
Other - Last Name:HART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:214 MAEDIRIS DR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30030-1114
Mailing Address - Country:US
Mailing Address - Phone:404-372-5087
Mailing Address - Fax:
Practice Address - Street 1:214 MAEDIRIS DR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1114
Practice Address - Country:US
Practice Address - Phone:404-372-5087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0201192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD40992Medicare UPIN
GA26BDKJGMedicare ID - Type Unspecified